APPLICATION FOR ADMISSION POSTGRADUATE …

1 APPLICATION FOR ADMISSION POSTGRADUATE STUDIESFOR OFFICE USE ONLYS tudent numberReceipt numberTshwane Universityof TechnologyWe empower people1 August 2015 Printing Services, TUTAPPLICATION FOR ADMISSION : POSTGRADUATE STUDIESTHE CLOSING DATES FOR applications ARE AS FOLLOWS:1. 15 June for all international 28 February for January intake or 31 July for July A non-refundable administration fee of R240 for APPLICATION ; certified copies of your identity document and all relevant qualifications; and the original academic record. If you pay the APPLICATION fee electronically or at a bank, the proof of payment must accompany the APPLICATION The APPLICATION fee can be deposited beforehand at: ABSA BANK ACCOUNT NUMBER: 04 000 0003 In the Reference column, please fill in your identity number. Send the deposit slip with the APPLICATION form. Please refer to the important information on the back of this page. NB. Do not use this account number for any further Encircle the applicable If you are applying for ADMISSION only, complete section A and page 5 of the APPLICATION If you are applying for ADMISSION and residence, complete sections A and B and page 5 of the APPLICATION you previously registered at TUT, Technikon Northern Gauteng, Technikon North West or Technikon Pretoria?

2 Yes NoIf yes, please indicate your student number: International applicant: Yes No Diplomat: Yes No Refugee: Yes NoSurname: Initials: SECTION APROPOSED QUALIFICATIONA pplication for ADMISSION : 20 When would you like to start with your course? January intake July intakeChoice of study: Type of proposed study: Research Structured Campus: Arcadia, Arts, Pretoria Ga-Rankuwa Soshanguve 2 IMPORTANT INFORMATION1. GENERAL It is in your interest to submit the APPLICATION forms as soon as possible and not to wait until the closing date for ap-plications. This form must be completed by all new students. If you were registered at the Tshwane University of Technology for the previous academic term or part thereof, you need not complete this form again. Block letters and black ink must be used for completing this form in full.

3 Applicants in need of accommodation must also complete this form. The prescribed administration fee of R240 must accompany this form and is not refundable. All applicants are subject to evaluation. You may not submit more than one APPLICATION form. If you wish to alter your choice at a later stage, you must do so in writing. NB: Documents that are sent by fax are not acceptable, but you may scan and e-mail the certified documents. Refer to the bottom on this page. The processing of your APPLICATION will be delayed: If you fail to complete this form in full, if you fail to attach all the required documents, if you fail to enclose the administration fee, if your APPLICATION reaches the University after the relevant closing date. The University must be notified immediately of any change of address after the submission of this APPLICATION . The reference number allocated to you must be quoted in all further correspondence.

4 Should you, after having submitted this APPLICATION , decide not to continue with your studies or to change your quali-fication, you must notify the Registrar of your decision immediately in writing. The University retains the right to reject any APPLICATION without stating reasons. All non-South African citizens must submit a study permit before registration. Provisional acceptance does not imply exemption from this requirement. Applicants will be informed in separate letters whether their applications for ADMISSION and accommodation were ADMISSION REQUIREMENTS Consult the brochure of the faculty concerned to find out whether you meet the ADMISSION requirements for your pro-posed study DOCUMENTS Certified copies of the following documents must accompany each APPLICATION : Identity document. Official proof that all the requirements for a diploma or degree have been met. An academic record in respect of studies at another tertiary UNIVERSITY RESIDENCES Accommodation in residences is available only in Soshanguve and Pretoria, and only for bona fide day-class AWARDING OF STATUS Prospective students who obtained qualifications at other higher education institutions must apply on the prescribed ap-plication form to be granted a certain status for further studies at the Tshwane University of LANGUAGE POLICY In accordance with the Language Policy of the Tshwane University of Technology, the language medium for lectures is ADDRESSESPRETORIA Registrar, Private Bag X680, PRETORIA, 0001 Staatsartillerie Road, Pretoria West,Tel.

5 086 110 2422, fax 012 382 5114E-mail: Initials: Title: Mr Mrs Miss Dr Prof Other_____Full names: Preferred name: If married, maiden name: Date of birth: Gender: Male FemaleIdentity number: Passport number: Marital status: S Single M Married D Divorced W Widow(er)Country of citizenship: 1 RSA 2 Permanent residence permit for South AfricaIf other, please specify Country: _____Study permit number: _____ Expiry date: _____Home language: A Afrikaans NS Sepedi TC Xitsonga E English TW Setswana V Tshivenda AE English/Afrikaans SE Sesotho X IsiXhosa ND IsiNdebele SW Siswati Z IsiZuluIf other, please specify: _____Race: We need the following information for reporting to Government: Black African Coloured Indian WhiteIf other, please specify: _____Are you currently employed: Yes No If yes, how many years: _____ 3 PERSONAL DETAILS M F4 PRESENT ACTIVITY BEFORE YOU START YOUR STUDIES 03 University of technology student 07 Labour force 01 University student If other, please specify: _____If you are registered as a student, please give the name of the institution: _____MEDICAL AID INFORMATIONName of medical aid: _____ Medical aid number: _____Main member: Title: _____ Initials _____ Surname: _____Identity number: Tel/Cell: _____Relationship to student: Father Mother If other, please specify _____Specific medical conditions: _____Do you make use of a wheelchair?

6 Yes No If yes, manual or electronic: _____DISABILITYIf you have a disability, but choose not to disclose it on this form, the Tshwane University of Technology is under no obli-gation to assist or accommodate you with regard to that disability. VI Blind or partially sighted HD Hearing (even with a hearing aid) IN Cognitive (difficulties in learning) NO None CO Communication (talking, listening) PH Physical (moving, standing, grasping) EM Emotional (behavioural or psychological) MU Multiple or physical please specify: _____If other, please specify: _____5 APPLICANT S POSTAL ADDRESSP ostal codeTelephone (H):Telephone (W):Cell:Fax:E-mail:APPLICANT S RESIDENTIAL ADDRESS (A post office box must not be indicated here)Postal codeSTUDY ADDRESS (if already known)Postal codeNEXT OF KINR elationship to the student: _____Surname: _____ Title: _____ Initials: _____Postal codeTelephone (H):Telephone (W):Cell:Fax:E-mail:ADDRESSES (all compulsory)Do you want to apply for accommodation in a residence?

7 Yes No Please note that selecting Yes is no guarantee of obtaining accommodation in a residence. Successful residence appli-cants will be notified via e-mail and sms from AND CURRENT TERTIARY STUDIESS tate the tertiary institution at which you have obtained the highest qualification and attach full academic recordsStudent numberInstitutionName of degree/diplomaCompletedDate on which degree was conferredYears From ToSECTION BRESIDENCE APPLICATION6 MEMORANDUM OF AGREEMENT Should my APPLICATION be successfulI, _____ declare that1. All particulars given by me in this form are true and correct;2. I will acquaint myself with the rules and regulations of the Tshwane University of Technology and will abide by them;3. I will inform the Registrar immediately, in writing, should I change my address or cancel or change my course or any subjects;4.

8 I am aware that my enrolment is valid only if it complies with the relevant regulations of the University; notwithstanding provisional ac-ceptance of this enrolment by the University;5. I am aware that fees and legal costs will be recovered from me should I fail to fulfil my financial commitments towards the University;6. I hereby give consent to the University and its subcontractors or op-erators to collect and process my personal information for the pur-poses of this agreement, provided such information is kept confiden-tial;7. I understand that subject to applicable laws and rules and regulations of the University, I may access the personal information TUT has about me by contacting the office of the Registrar and if necessary, request that corrections be made;8. I authorise the University to provide information relating to my studies and conduct while at the University to other educational institutions, my parents or legal guardian, my employer and my sponsors to en-able such a sponsor or funder to determine the continuation of such sponsorship or funding; 9.

9 I authorise the University to provide information relating to my studies and conduct to potential sponsors or potential employers to enable such potential sponsor or potential employer to decide whether to provide me with funding, training or employment opportunities;10. I grant the University permission to enquire and verify my qualifica-tions already obtained at other institutions; 11. I accept full responsibility for the payment of all class and/or resi-dence fees as well as any other fees determined by the Tshwane University of Technology;12. I accept that my examination results/ certificate/diploma/degree and study records may be withheld under the following circumstances: (a) In the event of my student account being in arrears, or (b) In the event of any disciplinary matter pending against me; 13. I hereby cede and transfer to the University all rights and title in any intellectual property created by me during my course of study or in any research project I undertake at the University, unless otherwise _____Signature of applicant DateHerein assisted as far as may be necessary while the applicant or student is still under the age of eighteen.

10 IT IS COMPULSORY THAT THIS CONTRACT BE SIGNED BY ALL PARTIES CONCERNED Tshwane University of TechnologyINDEMNITY AGAINST CLAIMS FOR LOSS OR DAMAGESI, _____(full name), the undersigned, hereby declare that I (including my depen-dants) shall not institute any claim of any nature whatsoever against the Tshwane University of Technology or any employee of the Tshwane Uni-versity of Technology, acting within his or her employment capacity, nor shall I in any way whatsoever hold the Tshwane University of Technol-ogy responsible for any loss or damage that I may suffer in person or in respect of any property of mine, or which may directly or indirectly arise from my commitment, as a registered student, towards the Tshwane University of Technology, resulting from any act or omission whatsoever during the full period of my tuition and/or practicals, or during any sport activity that I undertake, or during any time that I live in a residence of the Tshwane University of Technology, or during any trip or journey that I undertake to or from such residence or tuition or practical training or with regard to any activities at practical training locations.